The use of platelet-rich plasma remains controversial as treatment regimens and formula concentrations are not standardized, high- level studies proving efficacy are few and many health care systems hesitate to adopt the treatment due to lack of reimbursement. “ There is tremendous variability within platelet-rich plasma formulations,” Scott A. Rodeo, M.D.. of Hospital for Special Surgery in New York City, told Orthopedics ToDay. “ It is a complelling concept to isolate autologous cytokines and factors from blood, but we are still at the tip of the iceberg. It is in its infancy. We need to become more refined in the understanding of what we want to give to the patient”. The numerous brands, concentrations, does and uses of platelet-rich plasma (PRP) create a challenge in determining the best formulations of PRP for patients, according to Rodeo. The mechanisms for healing of PRP solutions vary and are dependent upon platelet numerous and captures, the efficiency of those captures from given blood samples, activation techniques, leukocyte counts and specific growth factors of proteins.
Orthopedics ToDay, April 2013

Researchers from the Rothman Institute found that patients who took aspirin following total joint replacement had a significantly lower rate of pulmonary embolism than patients on warfarin. “Aspirin is not only as effective as {warfarin} at preventing venous thromboembolic episodes, its use was associated with less bleeding, less wound discharge, fewer hospital readmissions, less reoperations and {less} incidence of infection,” lead study author Javad Parvizi, M.D., FRCS, Director of Research at the Rothman Institute in Philadelphia, said. According to a Thomas Jefferson University Press Release, the investigators assessed 1,824 patients who received aspirin (325 mg BID) and 24, 567 patients who received warfarin after joint replacement surgery at their institution between 2000 and 2011. They reviewed the incidences of pulmonary embolism (PE), readmissions, reoperations, infections, bleeding or wound complications up to 90 days postoperatively. They matched the patients for comorbidities and demographic variables. The aspirin group had a significantly lower rate of PE than the warfarin group (0.2% vs. 1%). Hematoma and seroma formation, wound problems, acute infections and 90-day mortality rates were not statistically significant between the groups.
Orthopedics ToDay, April 2013

Investigators of a level 1 study discovered that intra-articular aspiration provided temporary improvement in patients with effusion, particularly in those with a history of trauma, but the results soon deteriorated. “Aspiration results in better outcomes short-term,” Nikolaos K. Paschos, M.D., said during his presentation. “After the initial improvement in traumatic effusions, you may expect edema accumulation that deteriorates outcome.” He added, “Knee aspiration has a role in defining the diagnosis in cases that we do not know.”
Orthopedics ToDay, April 2013